Adolescent Patients’ Responses to Interpretations Focused on Endings in Short-Term Psychoanalytic Psychotherapy

Discussing endings is a crucial part of the work of short-term psychoanalytic psychotherapy with adolescents, but there are different views on how best this should be done and whether it is helpful or appropriate to link endings to interpretations of the transference. This study looks at how adolescent patients suffering from moderate to severe depression respond to interpretations around endings in a 28-session long, manualized psychoanalytic psychotherapy. Data come from a randomized clinical trial in which all sessions were audio-recorded. Purposive sampling was used to identify four sessions with four different adolescents in which therapists raised the issue of upcoming endings, explored the patients’ emotional responses, and linked these to the transference. The four extracts were transcribed and analysed using conversation analysis. Findings show that patients either emphasized or diminished the importance of their relationship to the therapists and the consequences of the separation from them in response to transference interpretations. They managed the conversational exchange by either “trouble-telling” or “story-telling.” The authors reflect on the implication of patients’ responses for treatment technique and consider whether transference work with adolescents should be paced and adapted more flexibly in short term psychoanalytic psychotherapy.